Author

Date of Award

2006

Availability

Article

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Psychology

First Committee Member

Michael H. Antoni, Committee Chair

Abstract

The present investigation examined the efficacy of group-based Cognitive Behavioral Stress Management (CBSM) with individualized Medication Adherence Training (MAT) delivered by a licensed clinical pharmacist. CBSM+MAT (n = 76) was compared to MAT-Only (n = 54) on measures of psychosocial adjustment, adherence and other health-related behaviors, neuroendocrine regulation, and immune status. Data were collected at baseline, immediately following the 10-week CBSM intervention period, 9 months post-randomization, and 15 months post-randomization. In the 130 men randomized, we observed intervention-related reductions in depressed mood and denial during the 10-week training period. Furthermore, we determined that intervention-related reductions in denial may mediate decreases in depressed mood over the 10 weeks. Other intent-to-treat analyses indicated no effects of CBSM+MAT on health-related behaviors, neuroendocrine regulation, and immune status. However, in the 101 HIV+ men with detectable viral load at baseline, men randomized to CBSM+MAT (n = 61) displayed a .56 log10 reduction in HIV viral load over the 15 months while men in MAT-Only (n = 40) showed no change. Intervention-related reductions in depressed mood during the 10-week training period mediated the effect of CBSM+MAT on HIV viral load in men with detectable plasma levels at baseline. Results indicate that a time-limited CBSM+MAT intervention that modulates depressed mood may enhance the effects of HAART on suppression of HIV viral load in HIV+ gay and bisexual men who have a detectable viral load.